Surgical Treatment of Peptic Ulcer Disease

Sachdeva, Ajit K.; Zaren, Howard A.; Sigel, Bernard

doi:10.1016/s0025-7125(16)30426-6

Cited by 26 publications

(16 citation statements)

References 42 publications

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“…The clinical presentation of gastric outlet obstruction in our patients is not different from those in other studies, 5,12,13,14,15 with non-bilious vomiting being common to all the patients. Pallor was present in 77.9% of cases.…”

Section: Discussioncontrasting

confidence: 53%

A Clinical Study of Gastric Outlet Obstruction in Adults

Sushruta¹,

Anmol²,

Namitha³

et al. 2015

jemds

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From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but is more often placed immediately proximal to the sphincter where the diagnosis of carcinoma is most probable or more distally in the duodenal bulb where the cause is almost invariably a duodenal ulcer. This study has been taken up to review the changes in presentation of gastric outlet obstruction in view of changing trends in the aetiology analysing the occurrence of benign and malignant causes, signs and symptoms, investigatory modalities, management and their results. The present study is an observational study a total of 50 cases were studied with Cicatrised duodenal ulcer and carcinoma pyloric antrum being the major causes. Clinical profile, investigations and treatment outcomes were analysed. The majority of patients had malignant gastric outlet obstruction with 32[64%] patients presenting with Gastric cancer and 18[36%] patients presenting with cicatrised duodenal ulcer. In this study most patients were in the fifth and seventh decades of life. Men outnumbered women by 3: 1. The clinical presentation is not different from those in other studies with non-bilious vomiting being common to all the patients with dehydration. Visible gastric peristalsis and succussion splash were more prominent in Cicatrised Duodenal Ulcer. All cases were subjected to serum electrolyte estimation. Out of them 20 cases [40%] showed electrolyte imbalance barium meal, ultrasound abdomen pelvis and CT scan abdomen being the other investigating tools. Blood group 'O' was common in cicatrized duodenal ulcer patients [77.7%] followed by blood group 'A' [11.1%]. Upper GI endoscopy was done in all cases [100%]. 32[64%] cases had pyloric antral Carcinoma in which 23 cases had fungating growth and the rest 9 had ulcerative growth and 18[36%] had cicatrized duodenal ulcer. 100% of cicatrized duodenal ulcer patients underwent truncal vagotomy with posterior gastrojejunostomy. In carcinoma of pyloric antrum, 56.25% underwent Billroth II Polya gastrectomy after subtotal resection and 25% underwent anterior gastrojejunostomy and 18.75% underwent feeding jejunostomy alone depending on the stage of the disease. The average hospital stay was 10 days. The overall mortality rate was 6% (9.3% for malignant cases). Mortality rate was zero in case of cicatrised duodenal ulcer. Surgical site infection was the most common post-operative complication accounting for 38.2% of cases. One patient with carcinoma pyloric region developed duodenal blow out on the 5th day and died due to biliary sepsis.

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Section: Discussioncontrasting

confidence: 53%

A Clinical Study of Gastric Outlet Obstruction in Adults

Sushruta¹,

Anmol²,

Namitha³

et al. 2015

jemds

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“…1–3 In the modern era of proton-pump inhibitors and eradication of H. pylori , GOO from PUD is a rare occurrence, and most are now due to periampullary malignancies. 4,5 The aim of surgery, especially for patients with advanced malignancies, is to re-establish oral intake and stabilize and improve quality of life. 6–8 Different modalities have been described for treating GOO.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Gastrojejunostomy for the Treatment of Gastric Outlet Obstruction

Zhang¹,

Tabrizian²,

Nguyen³

et al. 2011

JSLS

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“…4 In present study, 62.5% of patients were smokers and 47.5% of them had a history of alcohol consumption which is close to another study by Kozoll et al 20 Most common symptom was non bilious vomiting seen in 100% of the patients which is similar to other studies (Table 6). [2][3][4]11,21,22 Weight loss was noted in 59.5% of patients in series of Kozoll DD et al, and 32% in series of Dworken HJ et al, suggesting weight loss to be significant in patients with pyloric obstruction. Ca PA had vomiting as major symptom followed by loss of weight (93.54%) and loss of appetite (93.54%).…”

Section: Discussionmentioning

confidence: 99%

A clinical study of gastric outlet obstruction

Ashwin¹,

Visruja²

2018

Int Surg J

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Background: Gastric outlet obstruction (GOO) is a diagnostic and therapeutic challenge in developing countries to a Surgeon. Gastric outlet obstruction, a clinical condition impeding emptying of stomach mechanically, can be due to varied etiology. This study was taken up to know the etiological factors and management.Methods: This was a descriptive prospective study done at Madurai Medical College for a period of 2 years from September 2009 to August 2011. A set of inclusion and exclusion criteria were defined and followed. Upper gastro-intestinal endoscopy (OGD) was done in all cases while Barium meal study was done in few cases to make the diagnosis. Relevant operative procedure was done, and patients were managed post operatively.Results: Cicatrised Duodenal ulcer (DU) was the commonest cause followed by Carcinoma Pyloric antrum (Ca PA). Majority of the patients were males (67.5%) with male to female ratio of 2.07:1. Vomiting was one of the major presenting symptoms in all the patients.Conclusions: Cicatrised DU was the commonest cause for GOO in present study. Present study highlights the increasing incidence of Ca PA. This could be due to better management of DU at an early stage.

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Surgical Treatment of Peptic Ulcer Disease

Cited by 26 publications

References 42 publications

A Clinical Study of Gastric Outlet Obstruction in Adults

A Clinical Study of Gastric Outlet Obstruction in Adults

Laparoscopic Gastrojejunostomy for the Treatment of Gastric Outlet Obstruction

A clinical study of gastric outlet obstruction

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